After 80 years, in India’s fluorosis capital Nalgonda the disease is finally on the wane

“I was even taken to New Delhi to meet the prime minister years ago to inform the central government about my condition. So many people back then had fluorosis in my village, but they are mostly dead now," said Yadaiah. His condition, like that of thousands of others, was a result of consuming water high on fluoride content, which is naturally present in the soil due to its rocky terrain in most parts of Telangana’s Nalgonda district.

80 years after the first cases were discovered in Nalgonda district in 1937, fluorosis, a condition that causes dental and skeletal deformities, is finally on the wane in the present generation owing to better drinking water facilities and higher nutrition standards.

According to the district fluoride monitoring centre (DFMC), no new cases have been reported in the last few years. However, there is still an estimated 200,000 people among the 1.63 million people in Nalgonda district who are affected by dental, skeletal and non-skeletal fluorosis, making it one of the worst affected districts in the country, according to DFMC.

The DFMC is a tripartite body of the district administration, the fluoride knowledge action network (FKCAN), a non-governmental organization, and the United Nation’s Children’s Fund (Unicef) that was formed in 2014 to address fluorosis mitigation.

Like Yadahiah, Amshala Swami, 35, from Shivannaguda village, also suffers skeletal fluorosis.

“I had the condition when I was in my mother’s womb because she drank water high on fluoride. My sister also had the same thing and she died due to its severity," he added. Both Swami and Yadaiah get Rs1,500 from the state government as a pension due to their condition. Only those with 40% or more disabilities are entitled to this pension.

Spurthi Kolipaka, team lead, DFMC, said that 8,397 people with skeletal fluorosis get pension in the district.

Other states affected by fluorosis are Karnataka, Madhya Pradesh, Assam, Odisha, Gujarat and Andhra Pradesh, said Kolipaka.

The mitigation of this problem needs safe drinking water and good nutrition, said Dr Kranthi Kumar, medical officer from the national programme for prevention and control of fluoride (NPPCF), which was set up in 2012 as part of the twelfth five-year plan.

He said data is presently being collected to get the exact numbers of those affected by fluorosis in Nalgonda district, along with all the erstwhile 10 (now 31) districts in 2016 by the state government . “In the old Nalgonda district’s limits, 17 mandals out of 59 were severely affected and 31 moderately affected," said Dr Kumar.

According to DFMC, 0.5 to one milligram (mg) per litre is the permissible limit (in India) for fluoride content in water and the same is 0.5 to 1.5mg per litre as per the World Health Organization (WHO). But the levels in Nalgonda district were even found to be close to 10mg at places.

“Like me, anyone over 45 years of age suffers from dental fluorosis here due to the water we drank as children. Thankfully, we are now getting water from the Krishna river, so the present generation is safe," said Bokka Bhupal Reddy, sarpanch of M. Edavalli village. He recalled that people there were so poor at one point that they preferred to sell the eggs laid by their chickens instead of eating them.